Moore, Samantha Tyler
Moore, Samantha Tyler is an individual health care provider with primary practice located at 2003 Godwin Ave Ste C , Lumberton NC 28358-3150. She recently has only one registered license in Behavioral Health & Social Service Providers / Mental Health, which is considered as her primary health care specialty. Moore, Samantha Tyler can be contacted via phone (910) 240-2939.Contact Information
Primary practice address
2003 Godwin Ave Ste C
Lumberton NC 28358-3150
Phone: (910) 240-2939
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Mental Health | 101YM0800X | A13926 | North Carolina |
Profile Details
| NPI number | 1013405356 |
|---|---|
| LBN Legal business name | Moore, Samantha Tyler |
| Credentials | LPCA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Apr 23rd, 2018 |
| Last updated | Apr 13th, 2020 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1013405356 | NPPES |
| North Carolina | MEDICAID | 1013405356 |
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